Thanks Chris
Sent from my iPhone
> On 4 Aug 2014, at 21:07, "Chris Packham" <[log in to unmask]> wrote:
>
> Joanna
>
> Whichever method you decide to adopt, be cautious. I have on my files here
> details of a number of different approaches to the auditing of hand hygiene.
> Some use simple techniques, others more complex ones. However, when you
> consider them, none can be said to be the ultimate answer. All have a
> variety of shortcomings.
> Additionally, keep in mind the Hawthorne factor. How you allow for this is
> something that has never been completely resolved.
>
> Furthermore, hand hygiene is not the be all and end all of infection
> prevention. At the time the editor of the Journal of Hospital Infection, Dr.
> S.J.Dancer wrote:
> "It is time to balance the current obsession with hand hygiene by
> prioritising some of the other infection control options that we have,
> which, while undoubtedly more costly than posters and alcohol gel, provide
> some evidence for patient benefit regarding the risks of HCAI."
>
> And this brings me to the patient. I was taken ill back in 2008 and rushed
> to A+E. When I was finally transferred to a ward I was handed a card about
> ensuring that I challenged health care personnel about sanitising or washing
> their hands before touching me. Nothing about my own personal hand hygiene.
> Yet there are studies showing that a significant number of HCAIs are due to
> the patient infecting themselves. Whilst there was a dispenser of alcohol
> gel in my bed space, it was at the foot of the bed and unreachable by me. Of
> course, my wife on her first visit brought me a dispenser of alcohol gel!
> Interestingly, health care staff approaching me without sanitising their
> hands, on noticing this dispenser on my bedside cabinet, returned to the
> foot of the bed to use the gel there!
>
> Indeed, the whole topic is much more complex than many realise, even some of
> those working in infection prevention. For example, excessive hand washing
> can actually make the skin more easily colonised by infective
> micro-organisms, which are then more difficult to remove, thereby negating
> the benefit of hand washing. Many nurses I observed during my time in a
> hospital bed whilst attempting to wash their hands failed to rinse
> adequately, thereby negating the whole purpose of the hand washing. Will
> this be reflected in the audit and if so how?
>
> What is really needed is a comprehensive approach, covering design of
> facilities and equipment, proper risk assessment and the introduction of
> appropriate control measures, which will, of course, include, but not be
> limited to, hand hygiene.
>
> Best regards
> Chris
>
> Chris Packham
> FRSPH, FIIRSM, FInstSMM, MCMI, RSP, MBICSc
> EnviroDerm Services
> Unit 10, Building 11, The Mews, Mitcheldean, GL17 0SN
> Tel: 01386 832 311
> Mobile: 07818 035 898
> www.enviroderm.co.uk
>
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